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Massive Renal Cyst Displacing Intra-Abdominal Structures.

Khalid M G Mohammed¹, Ayaa Zarm^2,3, Juan Carlos Q Velez^2,3

¹School of Medicine, Tanta University, Tanta, Egypt.

Ochsner Journal

|September 15, 2023

Summary

Massive renal cysts are rare and usually asymptomatic. This case highlights limited noninvasive options for symptomatic massive cysts, suggesting monitoring and pain management for patients refusing surgery.

Keywords:

Cysts flank pain hyperkalemia

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Area of Science:

Nephrology
Radiology
Urology

Background:

Simple renal cysts are common, typically asymptomatic, and incidentally found.
Massive renal cysts are exceptionally rare clinical findings.

Observation:

A 77-year-old female with chronic kidney disease presented with hyperkalemia, abdominal distension, and flank pain.
CT revealed a massive right renal cyst (22 × 11 × 17.5 cm) causing displacement of intra-abdominal structures.
The patient's serum creatinine significantly elevated, indicating worsening kidney function.

Findings:

The massive renal cyst led to symptomatic presentation requiring urological evaluation.
The patient opted for conservative management, including pain control and monitoring, over surgical intervention.
Noninvasive treatment modalities for symptomatic massive simple renal cysts are scarce.

Implications:

Conservative management, including regular monitoring and symptomatic treatment, may be a viable option for patients who decline invasive procedures for massive renal cysts.
This case underscores the importance of considering conservative approaches when managing rare, symptomatic renal masses in patients with comorbidities.
Further research into noninvasive management strategies for massive renal cysts is warranted.